9. Check if this filing amends a previously filed version of this report

10. Check if this is a Termination Report

Termination Date

11. No Lobbying Issue Activity

INCOME OR EXPENSES - YOU MUST complete either Line 12 or Line 13

12. Lobbying

13. Organizations

INCOME relating to lobbying activities
for this reporting period was:

EXPENSE relating to lobbying activities
for this reporting period were:

Less than $5,000

Less than $5,000

$5,000 or more

$

$5,000 or more

$

70,000.00

Provide a good faith estimate, rounded to the nearest
$10,000,
of all lobbying related income from the client (including all
payments to the registrant by any other entity for lobbying
activities on behalf of the client).

LOBBYING ACTIVITY.
Select as many codes as necessary to reflect the general issue areas in which the registrant
engaged in lobbying on behalf of the client during the reporting period. Using
a separate page for each code, provide information as requested. Add additional page(s)
as needed.

15. General issue area code MMM

16. Specific lobbying issues

Medicare: Urged lawmakers to extend key hospital provisions and reject cuts to Medicare and Medicaid payments for provider services as part of any final agreement to extend the Social Security tax holiday, unemployment insurance benefits, and physician fix. Opposed reductions to Medicare bad debt for hospitals, nursing homes, clinical lab payments, and rebasing Medicaid DSH.Strong support for eliminating planned Medicare cuts to physicians and opposition to doing that by reducing payments to providers. Support for extension of other healthcare policies, including: MMA section 508 reclassifications, exceptions process for Medicare therapy caps, and outpatient hold harmless payments.

Strongly oppose proposals included in the Administrations FY2013 budget blueprint that included $320 billion in reductions to Medicare and Medicaid as part of their $3.8 trillion budget plan. Specifically, oppose reductions to bad debt, IME, reductions to post acute providers, and strengthening the IPAB. As well as opposed proposed reductions to Medicaid provider taxes, Medicaid DSH, and changes to Medicaid payment formulas.

Strongly oppose Medicare and Medicaid reductions included in the Houses FY2013 Budget Resolution, which proposed to cut more than $5.3 trillion in government spending over the next 10 years, approximately half of which would come from health care. The proposal called for a budget reconciliation process, directing six House committees, to produce legislation reducing the deficit by at least $18 billion in the first year and $261 billion over 10 years. The proposal called for eliminating the sequester cuts for defense and non-mandatory discretionary spending, Medicare sequester cuts, approximately $6 billion over 10 years, remain in place. Among other proposals, the budget plan would rescind the individual subsidies and Medicaid expansions included in the ACA, while keeping the $500 billion in Medicare cuts included in the law. The budget also would convert Medicaid into a block grant program, reducing federal Medicaid spending by $5 billion in 2013 and $810 billion over 10 years.

Support efforts to urge HHS to extend current relief from full implementation of the 25% rule affecting long-term care hospitals (LTCHs) for an additional hospital cost reporting period and/or at least until the end of 2012 in order to give Congress an opportunity to resolve many of the issues affecting LTCHs.

Urge support for application submitted to CMS to convene an expansive Medicare physician/hospital gainsharing pilot in New Jersey. The application was submitted in response to a request for applications (RFA) by CMMI for organizations interested in conducting a Bundled Payments for Care Improvement Initiative.